Lymphedema
is a swelling of a limb and/or part of
the body because of a functional inability of the lymphatic system to
transport
intercellular lymphatic fluid back to the circulatory system.
Lymphatic
fluid becomes stagnant, leaving the patient prone to
infection. When
infection occurs, many patients require treatment with antibiotics and
costly
hospitalization. Lymphedema can affect arms, legs, breast,
back, abdomen,
groin and genitalia.
Congenital (primary) lymphedema is caused by a malformed or
underdeveloped
lymphatic system, and can be present at birth, develop at puberty, or
occur at
older ages.
Secondary lymphedema can be caused by trauma or surgical resection,
radiation,
infection or disease involving the lymphatic system. The
greatest
incidence of secondary lymphedema in the United States occurs in cancer
patients
(breast, melanoma, sarcoma, gynecological, prostate).
30 % of all breast cancer axillary node dissection and inguinal node
dissection
patients will develop lymphedema over their lifetime.
In the entire United States, of the 203,500 newly
diagnosed cases of
breast cancer projected for YR2002, 61,000 will develop
lymphedema! Also
requiring treatment are the survivors of uterine and cervical
cancer,
prostate cancer and melanoma treatment, adding an estimated 88,500 new
lymphedema patients requiring treatment in 2002. (American Cancer
Society Facts
and Figures 2002.)
The above estimated 149,000 new cases of lymphedema will be added to
the
millions of existing diagnosed and undiagnosed cases of primary and
secondary
lymphedema.

How
is it treated?

Treatment
procedures have been developed in Europe over the last 30 years, but
have only
been accepted by American medicine for the last 10
years. The
current standard of treatment for lymphedema is called "complex or
complete
decongestive therapy," and it has been the recommended protocol in
Europe
since 1995 (International Society of Lymphology) and in the U.S. since
1998
(American Cancer Society Lymphedema Workshop). The American
Physical
Therapy Association (APTA), Guide to Physical Therapy Practice,
recommends
typically 5 -24 sessions be performed for acute management and periodic
follow
up as indicated. The acute treatment program consists of
manual lymph
drainage, low-stretch bandaging, exercise, skin care, and instruction
in
self-management, including the fitting and procurement of
compression
garments, bandages and devices. Phase 2 of the treatment
program, the home
treatment phase, continues for the life of the patient, and consists of
self-manual lymph drainage, day-time compression garments, night-time
bandaging
with multi-layer low-stretch bandages or manually-adjustable
compression
devices, skin care and exercise while under compression.Why
is insurance coverage needed?

Medicare has no
national medical policy for the
treatment of lymphedema and routinely denies coverage for components of
the
currently accepted treatment. Many patients have had Medicare denials
for
compression bandage systems and compression garments reversed by
Medicare
Administrative Law Judges, but only after many expensive
appeals. Only
twenty three states require all private health insurers to provide
lymphedema
coverage for breast cancer survivors.

Many medical providers fail to provide medical treatment to the current
recommended standard of care partly because of lack of knowledge of the
current
medical standard of treatment for lymphedema, and partly because they
do not
understand the favorable economics of lymphedema treatment.
There is currently no law mandating treatment of lymphedema from causes
other
than breast cancer.
Currently in many private insurance companies limit the number of
treatment
visits and/or do not cover compression garments, bandages, and
devices.
Insurers should at the minimum provide the minimal standard of care as
outlined
by the APTA-Physical Therapy Practice and provide replacements of
compression
orthotics to encourage patient compliance with their lymphedema
treatment plan.What
is the cost of mandating lymphedema treatment?

Treatment of lymphedema
can shown to save
significant amounts of money for the medical provider, the State and
the
patient. For example, savings in medical expenses over a forty year
survival
lifetime for treating a woman diagnosed with breast cancer at age 40
has been
estimated at close to $400,000.
Treatment of lymphedema has been shown to reduce and/or eliminate the
incidence
of infection (cellulitis and lymphangitis) encouraged by stagnant
lymph.
By reducing the number of hospital admissions and doctor visits,
providers will
see reduced cost. It can be demonstrated that proper
treatment of
lymphedema and compliance by patients with daily protocols is not only good
medicine, but it is good business and a
cost saving tool for
insurance companies!
Proper treatment and management of lymphedema can enable patients
living with
lymphedema to continue to live productive lives.

Children
with Lymphedema
The time has come for families, parents, caregivers to have a support
group of
their own. Support group for parents, families and caregivers of
chilren with
lymphedema. Sharing information on coping, diagnosis, treatment and
prognosis.
Sponsored by Lymphedema People.

No matter how you spell it, this is another very little understood and
totally
frustrating conditions out there. This will be a support group for
those
suffering with lipedema/lipodema. A place for information, sharing
experiences,
exploring treatment options and coping.

If you are a
man with lymphedema; a man with a loved one with lymphedema who you are
trying
to help and understand come join us and discover what it is to be the
master
instead of the sufferer of lymphedema.

All
About Lymphangiectasia
Support group for parents, patients, children who suffer from all forms
of
lymphangiectasia. This condition is caused by dilation of the
lymphatics. It can
affect the intestinal tract, lungs and other critical body areas.

While we have a number
of support groups for lymphedema... there is nothing out there for
other
lymphatic disorders. Because we have one of the most comprehensive
information
sites on all lymphatic disorders, I thought perhaps, it is time that
one be
offered.